Vedat NİSANOĞLU, Bülent ÖZGÜR, Süleyman SARI, Mustafa ALDEMİR, Yüksel AKSOY, Bektaş BATTALOĞLU, Hasan Berat CİHAN, Ertan YETKİN, Nevzat ERDİL

Koroner Arter Cerrahisi Yapılan Hastalarda Koroner Kollateral Dolaşımın QT Dispersiyonu Üzerine Etkisi

Amaç: Bu çalışmanın amacı koroner arter bypass greftleme yapılan hastalarda koroner kollateral dolaşım yapısının ameliyat öncesi ve sonrası QT dispersiyonu (QTd) üzerine etkisini araştırmaktır. Gereç ve Yöntem: Koroner arter cerrahisi yapılan 52 hasta çalışmaya alındı. Hastalar, koroner kollateral damarların varlığına göre sol koroner sistemden sağ koroner sisteme (Grup 1, n=13), sağ koroner sistemden sol koroner sisteme (Grup 2, n=15) ve kollateral dolaşım yapısı olmayanlar (kontrol grubu, n=24) olmak üzere 3 gruba ayrıldı. Tüm hastalarda ameliyat öncesi ve ameliyat sonrası 1., 5. ve 30. günlerde, 12 derivasyonlu elektrokardiyografi çekilerek QTd hesaplandı. Bulgular: Preoperatif hasta özellikleri kıyaslandığında koroner kollateral dolaşımı olan Grup 1 ve Grup 2 hastalarda hipertansiyon sıklığı kontrol grubuna göre daha fazla bulundu. Grup 2' de ameliyat öncesi ortalama QTd, kontrol grubu ve Grup 1' e göre istatistiksel anlamlı biçimde uzun bulundu. Ameliyat öncesi değerlerle kıyaslandığında, kontrol grubu ve Grup 1'de ameliyat sonrası QTd değerlerinde belirgin kısalma tespit edildi. Bununla birlikte, Grup 2' de ameliyat sonrası ölçümlerin hiçbirinde QTd' de anlamlı bir değişiklik bulunmadı. Sonuç: Çalışma, koroner arter cerrahisi sonrası QTd' de azalma olabileceğini göstermiştir. Bununla birlikte, cerrahi revaskülarizasyon yapılan hastalarda koroner kollateral dolaşım varlığının ameliyat öncesi ve sonrası QTd üzerine etkisi yoktur. Anahtar kelimeler: Koroner dolaşım, Koroner hastalık, Koroner arter bypass, QT dispersiyonu.

Anahtar Kelimeler:

Koroner dolaşım, Koroner hastalık, Koroner arter bypass, QT dispersiyonu

Effect of Coronary Collateral Circulation on Preoperative and Postoperative QT Dispersion in Patients Undergoing Coronary Artery Bypass Grafting.

Objective: This study is designed to investigate the effects of coronary collateral circulation on preoperative and postoperative QT dispersion in patients undergoing CABG operation. Method: Fifty-two patients undergoing isolated coronary artery bypass were enrolled in this study. These patients were classified according to the presence or absence of collateral vessels into 3 groups; presence of collateral vessels from right coronary system to left coronary system (Group 1, n=13), from left coronary system to right coronary (Group 2, n=15), and absence of collaterals (control group, n=24). In all patients, 12-lead electrocardiography was recorded to calculate QT dispersion preoperatively and on the first, 5th, and 30th postoperative day. Results: Comparisons of the groups' preoperative characteristics identified a significantly higher prevalence of hypertension in Group 1 and Group 2 than that in control group. Mean preoperative QTd was significantly prolonged in Group 2 than that in control group and in Group 1. There was a significant reduction in QTd from before surgery to all postoperative measurements in control group and in Group 1. However, mean QTd in Group 2 did not showed a significant decrease after surgery in Group 2. Conclusion: The study showed that coronary artery bypass grafting may reduce QTd. However, presence of collateral circulation in patients undergoing coronary artery surgery did not affect preoperative and postoperative QTd. Key Word: Collateral circulation, Coronary disease, Coronary artery bypass, QT dispersion.

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